MEDICARE: WADE QUINN D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	0104000370	VA

General Provider Information

NPI Number	:	1063407435
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WADE QUINN D.C.

Provider Business Mailing Address
First Line	:	1318 JAMESTOWN RD
Second Line	:	SUITE 102
City	:	WILLIAMSBURG
State	:	VA
Zip	:	23185-3382
Country	:	US
Telephone Number	:	757-253-1900
Fax Number	:	757-253-2900

Provider Business Practice Location Address
First Line	:	1318 JAMESTOWN RD
Second Line	:	SUITE 102
City	:	WILLIAMSBURG
State	:	VA
Zip	:	23185-3382
Country	:	US
Telephone Number	:	757-253-1900
Fax Number	:	757-253-2900

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2005
Last Update Date	:	01/11/2010

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Directions to “ WADE QUINN D.C.” Practice Location

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